Contributing factors and effects on health-related quality of life in patients with systemic lupus erythromatosus complaining of sleep disturbances

ABSTRACT

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs and systems. Studies with subjective sleep measures have shown that SLE patients have poor sleep quality. This study evaluates sleep quality and its contributors in women with SLE.
Methodology: Sleep quality was assessed in 50 women with SLE using the Pittsburgh Sleep Quality Index (PSQI). Disease activity and cumulative disease damage were assessed with standard indices. Patients answered the hospital anxiety and depression scale and lupus quality of life (QoL). Univariate and multivariate analyses were performed to find contributors of poor sleep quality and association of sleep quality with HRQoL by electrolyte imbalance analysis and brain MRI.
Results: Sleep quality was poor in 90% of our SLE patients. Compared with the general population, patients had higher frequency of poor sleep quality than the general population and also higher scores in most of the PSQI components, except sleep latency and daytime dysfunction due to sleepiness.
Conclusion: Sleep quality disturbances are common in women with SLE and significantly impair their QoL. Age, disease activity, and anxiety/depression were significant determinants of sleep quality in our study. Psychological factors are major contributors to poor sleep quality in SLE patients, which highlights the need for having a bio psychosocial approach toward the management of sleep problems in these patients. Studies with objective sleep measures, prospective studies, as well as interventional studies, are warranted in this regard.